Changes to the maternity system!!
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Topic: Changes to the maternity system!!
Posted By: Rachael21
Subject: Changes to the maternity system!!
Date Posted: 11 July 2011 at 10:23am
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Are any of you aware the changes the current minister of Health has planned for the maternity system and midwives?
As a bit of a background just over 20 years ago the women of New Zealand fought for the maternity system we have now. Previous to that most women were cared for by doctors and midwives would look after them in the hospital and change each shift. Now we have the continuity of care model which is looked on highly by the world of midwifery as the best care model for women. New Zealand is often used as an example of how to do things! Unfortunately in New Zealand it is not viewed as highly and one of the changes the minister of health wants is for new graduate midwives to work a year on a secondary/tertiary unit (secondary or tertiary are the hospitals that offer caesarean sections) before being 'allowed' to work as an LMC in the community. The thought of new grads working in a hospital probable doesn't seem like such a bad idea so I'll point out the flaws in this plan: -The hospitals are not set up to deal with that many new members of staff. So where will these new grads go then? We already have a shortage of midwives and the fact that the midwife population has an older average age meaning we need newly qualified midwives to stay in New Zealand! As well as the fact hospital midwives are paid quite poorly compared to other countries. Anyone that has had to ring around several LMCs before they could find one who would take them can understand why we need more LMCS! -We know working in a secondary/tertiary gives midwives a hugely skewed view of 'normal' birth as a lot of what they see are complex situations. Hospital staff have very little to do with normal births, they might be in the room for 10 minutes and then leave. Therefore once these midwives become LMCs they are more likely to use interventions. As it is intervention is widely overused in all countries not just New Zealand without any decrease in the maternal or neonatal mortality rate. -There are huge shortages of midwives in rural areas of New Zealand, the urban centres have just about come right with midwife numbers. The new midwifery programme was set up so students could do the course in their rural areas and then be able to stay and work there. This new 'plan' means students will have to leave once they are qualified doing nothing for the shortage in rural areas. -New graduate midwives are safe practitioners! The outcomes for new grads was recently looked into and there was no difference for livebirths, stillbirths, babies born with abnormalities and babies that died within a month of birth with a new graduate as an LMC or a more experienced midwife as an LMC. On average it will take a midwfe 13 years of practice before getting a HDC complaint, the rate of complaints against new grads is about 0.02% despite the fact that new grads have an overall higher risk caseload than more experienced midwives. -New graduate midwives have the option of joining a programme called the first year of practice programme which joins them up to an experienced midwife as a mentor . Most new grads take this up and the ones that don't are usually either working in the hospital or delaying starting practice. -What is the reasoning behind this decision? It can't be due to lack of skills of new grads. There is no research to show new graduate midwives are anything less than as competent as their more experienced colleages. As well as the fact that midwifery students are now taking part in a longer degree since these studies have been done. The hours have increased from 3600 to 4800 which is the equivalent hours as a four year degree. The final year has 33 weeks of practical and is essentially an apprenticeship type year. So how does this affect you? Firstly it will not affect hospital services at all if it doesn't go through. This will change the way midwives will practice in years to come. It will affect the numbers of LMCs available, it will affect intervention rates. As well as the cost of such a programme! We need midwives who specialise in normal birth. We have plenty of midwives and doctors who specialise in complications and they do an awesome job! Midwives are there to protect normal birth and identify when the situation is becoming abnormal. This involves being able to support women through childbirth without using unnecesary intervention. Basically the women of New Zealand deserve midwives who trust them to birth their babies, this may be lost with the proposed changes! What can you do? Ideally vote out national  but honestly that seems quite unlikely so talk to your local MP about what their plans are, talk to the media on how we do not want these changes to go ahead. Talk to each other about how this is not okay. Birth has been 'taken' by medicine before and we had to fight hard to get it back. Talk to your mothers and grandmothers on what it was like to give birth then. We cannot sit back and watch as choices get taken away.
Anyway thanks for reading my novel I will leave it with a quote... "Before birth belonged to medicine it belonged to women" |
Replies:
Posted By: MissCandice
Date Posted: 11 July 2011 at 6:36pm
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Rach! That was very well said.
This is something i am very concerned about given i am in first year. I will come back and reply properly once Kylah is in bed. ------------- ~ Mummy to a beautiful girl ~ |
Posted By: AandCsmum
Date Posted: 11 July 2011 at 7:52pm
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Completely unaware! thanks for informing us Rach ------------- Kel http://lilypie.com"> 
A = 01.02.04 & C = 16.01.09 & G = 30.03.12 |
Posted By: linda
Date Posted: 11 July 2011 at 10:57pm
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Not about to vote out National and I'm a kind of hospital with intervention type person when it comes to me having children so I guess in a way I don't mind the new measures
------------- http://lilypie.com"> 
Alex 6 and Harry 8 |
Posted By: WestiesGirl
Date Posted: 11 July 2011 at 11:42pm
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I hope they dont change the current model in NZ. Im in Aus and use the 'Shared Care' option, so most care with my GP and 5 milestone appts with the Obs and/or MW's at the Hospital. Technically no LMC.
If in between normal visits I need to see someone in relation to my health or baby's health, I can choose to pay to see my Dr (who will refer me to the hospital anyways cos he doesnt have the facilities or knowledge) or go to the Hospital and wait to see a MW I'd never met before. I spent Saturday and most of Sunday at the hospital and although the care was great from the MW's, I waited forever. I checked in at 1.30pm with a leakage complaint (turned out to have blood and protein in pee), saw a MW at 3.30pm and didnt see a Dr until 11pm Saturday night, before deciding it was best to keep me in. 9.5 hours after first arriving at the Maternity Ward! Sunday morning was a bit better. Had scan done to check baby and my Kidneys at 9.45am and saw a Dr at 1pm who then wanted me to stay but agreed to let me go. Anyways before I digress, I dont know if I had of been in NZ if I'd have gone through the same hideous process but my god, I'd hate for NZ to adopt a model like this one. I am all for having ONE LMC, I cant wait to get back to NZ in 4 weeks so I have that consistent care. ------------- Our Angel July 08  Gone but not forgotten
And to complete our family, our princess has arrived 
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Posted By: SophieD
Date Posted: 11 July 2011 at 11:51pm
I'm the same really so I guess it doesnt really bother me. I know nothing about midwife training (I'm hopelessly naive when it comes to any medical profession,lol) but it actually amazes me that midwives don't currently have a prescribed ongoing training program for their first few years practicing. As a teacher, I had a 2 year provisional period before becoming a fully qualified teacher and most professions I know about (granted that is by no means all of them lol) have some kind of required training during your first few years. Can understand that HAVING to work in a hospital environment would not suit everyone though and might be difficult to implement given what you say about hospitals taking first years. ------------- http://lilypie.com">  http://lilypie.com">
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linda wrote:Posted By: Hopes
Date Posted: 12 July 2011 at 5:58am
Yea, I totally know what you mean here! It would make me a bit nervous having a new MW, even though I know they do lots of work with experienced MWs while training. I think about how much I stuffed up in my job in the first few years and how much more confident I am now... In saying that, I also agree that perhaps churning out MWs with hospital backgrounds isn't ideal. I do like the idea that in theory, they'd be experienced in things that can go wrong, and that suits me. On the other hand, like the OP said, birth's a natural process and I'd say you'd get to see more intervention at the hospitals, and we might end up with a lot of MWs tending to recommend it because that's what they're familiar with. -------------   
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Posted By: susieq
Date Posted: 12 July 2011 at 7:37am
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Registered nurses used to train in the hospitals, i think it is a good idea for training to occur in the hospitals for both midwives and nurses
------------- susie |
Posted By: AandCsmum
Date Posted: 12 July 2011 at 7:53am
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My friend is a training MW, in her second year, and the amount of hospital shifts she is doing surprised me.
They are doing their training in a hospital environment as well as having to train under an independent mw as well as completing all their course work and assignments/exams. I hardly see her because she's always studying or working. Their studying year is far longer than a normal student, they definitely don't get the weeks off that other students do. ------------- Kel http://lilypie.com">
A = 01.02.04 & C = 16.01.09 & G = 30.03.12 |
Posted By: Plushie
Date Posted: 12 July 2011 at 8:06am
| I had a third year student deliver DS, she was absolutely ready to go. My regular midwife may as well not been there (though she was great as well but she did hang back and let the student do her thing). I wouldnt have seen a need for this particular student to have a training year and i assume all other students are a similar quality. The only thing she failed at was inserting a lure, but she got 5 practice runs on me! Perhaps new graduates could have limits instead, like taking on less mothers and having to have a supervisory m/w for high risk cases. Or make the mentor progam compulsary. |
Posted By: SophieD
Date Posted: 12 July 2011 at 8:18am
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Making the mentor program compulsory sounds like a much better idea then making everyone start in a hospital at least then they could practice in an environment that suits them.
In saying that, I don't believe 1 year in a hospital environment would fundamentally change a persons beliefs about intervention, if anything it would probably reinforce them. I also believe woman can have completely in control natural experiences in a hospital environment, we are much more educated these days and aware of what we are entitled to iykwim, so an inexperienced mw would still get the benefit of lots of different experiences. ------------- http://lilypie.com"> http://lilypie.com">
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Posted By: RedHeadDuck
Date Posted: 12 July 2011 at 9:18am
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I had a brand new midwife when I was pregnant. In fact I actually fell pregnant before she graduated, so had to wait for her to graduate to officially be under her care!
She was absolutely fan-bloody-tastic!!!! Would not hesitate in recommending her to anyone! She was SO knowledgeable and so professional you would not have known she had only just graduated. Compared to the backup midwife I had (when incidentally my midwife was away for another course...) she was so much more up with everything, she was fresh out of training and still knew everything, she had plenty of experience and there was not once I was concerned with her care, or worried or anything. She was so professional, done a bloody brilliant job of keeping us calm while needed, yet still doing her job.... I don't see why some people are so hesitant about new midwifes- they have an incredible amount of training and do so much on-job stuff before they graduate anyways. And off memory my midwife still had to do a few papers and supervision stuff after she graduated (something about writing up stuff about cases she managed- what went wrong, how it was dealt with and so on) so it's not like they go off into the land of nothingness... But this still isn't enough to make me want to vote out national I'm sure there would be enough of an up-roar about this that they wouldn't let it go through... Power of people and all that, ya know?
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Posted By: MissCandice
Date Posted: 12 July 2011 at 9:37am
Just wondering what will happen when your children want to have children and there are limited or no LMC's left to care for them? What if they dont want hospital intervention type care? ------------- ~ Mummy to a beautiful girl ~ |
Posted By: AnnaShev
Date Posted: 12 July 2011 at 12:56pm
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20 years ago the doctors providing the majority of maternity care were the women’s own GP's whom in most cases had been caring for that woman and her family for most of her life. Also then, to be a midwife you had to have trained as a nurse and done 2 years of practice as a nurse before you could begin post graduate training to become a midwife. Also 20 years ago women could stay in hospital for longer than 48 hours which allowed for good establishment of breast feeding and the teaching of mother craft to new parents. Midwives were based in hospitals because that was where they were needed. They cared for the new mothers, or those that needed specialised care. I write this because the original post makes it appear midwives were not valued or respected members of the healthcare team.
Today a 17/18 year old can walk out of high school and go straight into midwifery training. I have always been taught midwives need life experience and maturity, to me a 20/21 year old does not have these two qualities. It has been stated that hospitals take only a small percentage of new graduate midwives, however how many of these new midwives are staying in the place they trained? For example: I live in Invercargill, the nearest midwifery training school is Dunedin so if I were to train as a midwife I would have to do my training in Dunedin. Once I finished my training I would probably return to Invercargill as this is where my husband has a job and we own a house. So how many in your class are in a similar situation where they have only temporarily relocated so that they can gain their degree but have no intention of staying within the area? Also as I have previously stated 17/18 year olds can train as midwives, so how many of them have the intention of gaining their degree than going overseas? Many of the cases that I have seen and/or read about where there has been adverse outcomes in relation to new midwives have been where the situation has become complex is because the midwife has not known how to deal with the situation and has not been aware of the early signs that something isn’t right, so how can them being exposed to these situations in a controlled environment such as a hospital where help is there already be a bad thing? People have said that how can they learn if they aren’t allowed to make mistakes and that they made heaps of mistakes when they started their jobs, but if a midwife makes a mistake they have the potential to kill a mother and/or her child. A few years ago I started my nursing degree, as part of this we spent some time in a maternity unit and I would have to say, it left a lot to be desired. The midwives were more concerned about when there coffee was coming from than their clients and many of them were also LMC’s! I even heard one state she was too tired to look after her client (whom was in labour) and she was going home and to call her when the baby was ready to be delivered. (i dont object to her going for a rest, but the fact shge went home and appeared to not give a s*** about the client bothered me). I’ve also been told of women going in with well controlled diabetes and having severe hypos because the midwives don’t know how to care for diabetics (I’m hoping this one is not completely true) I feel that our maternity system leaves a lot to be desired, mostly because there is no choice in who provides the care, for me I would be more comfortable with a doctor namely, my GP who I find excellent. And for anyone who thinks Anna you don’t have children yet how can you possibly comment on this issue, I am a female, I want children, I believe we are in charge of our own healthcare and we should fight for what we believe in, I just believe that our current maternity system is not the best so I possibly will vote national, mostly because labour gave us this crappy system so if national are going to change it, go them. ------------- http://daisypath.com" rel="nofollow">   <
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Posted By: JoJames
Date Posted: 12 July 2011 at 3:01pm
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Well said Anna, I do think that the Midwifery system needs changing. There are babies dying that don't need to, and I do realise they are the exception not the rule, but MW's need to be more controlled and accountable just like (as previously said) Teachers, nurse, doctors are.
The way RachandJack has said that they are planning to change is not feasible because you will then end up with the situation where there are only new graduate MW's in the hospital and thats not safe, but I do think having some hospital experience is important because its good to know what normal and abnormal looks like and in a hospital where many births are happening each day you are going to see that much more than 3-4 births a month on a normal caseload. ------------- http://www.alterna-tickers.com"> 
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Posted By: AandCsmum
Date Posted: 12 July 2011 at 4:35pm
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Jo, they do heaps and heaps of hospital hours in their training and that is on top of the "following" that they do of qualified mw's.
I think perhaps that more people also need to be made aware of how midwives are trained & what study they have to do as well as what practical experience they have over the 3-4 years that they do their degrees. ------------- Kel http://lilypie.com">
A = 01.02.04 & C = 16.01.09 & G = 30.03.12 |
Posted By: Rachael21
Date Posted: 12 July 2011 at 4:39pm
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The point I'm trying to get across is not that there isn't a place for hospital midwives but that there is a choice for every woman to be able to choose a midwife that suits her philosophy. As I have said the course is the equivalent hours of four years, add on the mentorship year and that is 5 years. I would personally quite like the mentorship programme be compulsory and I think it will probably be that way in the next few years.
As I have said previously midwives going before the health and disability commissioner are very rarely new graduates. There are plenty of doctors/nurses/any health practitioner that go before the HDC the media just likes to make us believe it is mainly midwives. Look at the statistics! Anna - The new programme does offer training in Invercargill, that is what I was meaning. The 'satellite' groups that are based in smaller areas are the ones that want to stay. Like anything you cannot guarantee students will stay but it's aimed so that more will. In my original post I said hospital midwives are valued greatly and have always been, its the fact that is was a different midwife at each shift that wasn't so great. 17 year olds can get into the course but who is to say they will, anyone under 20 got extensively interviewed, midwifery doesn't have a huge amount of places and you would be surprised at the amount of life experience some 18 years olds have compared to the lack some 40 years old have. Lastly I have done many shifts in nursing areas and can honestly say I find midwives attitudes a lot better than some nurses but who can really say given that I haven't met every nurse and you haven't met every midwife. Anyway the main point I wanted to get across was it is all about choice. If you want a high intervention birth that will still be available but in twenty years will there still be the same option for women wanting a no intervention birth? I'm quite interested to hear what people think the 'ideal' maternity system would be then? Because if you don't want continuity of care it will go back to different midwives doing visits, shifts changing during labour and a doctor walking in to catch the baby? Because if you want that you can easily go through the hospital system anyway or pay for a private OB. GPs chose to stop doing obstetrics, they can still do it easily but they don't want to. Lastly has anyone ever watched '16 and pregnant' or 'maternity ward'? That is the opposite of our system and funnily enough with all those doctors and intervention their outcomes are worse than ours! Holland has a high home birth rate and have some of the best outcomes in the world... |
Posted By: fairy1
Date Posted: 12 July 2011 at 5:36pm
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Nurses have to do a New Graduate program otherwise they are very difficult to employ so why shouldn't midwives? I think they should have to do a year in the hospital to gain experience then they can become independent LMC's. I don't think it will affect the ways midwives practice in a negative way, if you want to be a midwife then you will do it and will still be a LMC.
Personally, I don't feel safe with midwives and didn't want to be under their care, and that was before I became categorised as a high risk pregnancy. ------------- http://lilypie.com"> 
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Posted By: AnnaShev
Date Posted: 12 July 2011 at 6:42pm
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Yes some 18 year olds do have a lot of life experience and generally can be more open to new ideas and education than older people. But a lot don’t.
Not all GPs chose to stop obstetrics, when the system changed it made it harder for them to practice mostly due to funding changes so ok yes ultimately they did make the choice to stop that part of their practice, it was not made "freely”. They were pushed out. I have watched 16 and pregnant, and in my opinion part of the reason for the high intervention rate is because the 16 year old body is not ready to have babies! At 16 girls most girls are not finished puberty so while it is possible for them to get pregnant doesn’t mean that they should. No I have not met every midwife, and yes there are probably midwives, who give the job everything and then some, but to come across these ones who were LMC’s I would hate to think what they were like outside the hospital environment. But they may not have been hospital people. The satellite programmes allow you to do your theory papers online, but all practical papers or assessments need to be completed at the base school and are number dependant. But the same could be said for any programme. How can using your GP not be continuity of care??? Again using myself as an example I have been with the same GP practice since birth (by a GP) it is also the same practice my parents are with, so effectively my GP has a complete health history not only for me but also for my parents. The shift change is going to happen no matter what system is used and the different person each time is tried to be minimised as the staff member should have the same patients for the duration of their work week where possible. ------------- http://daisypath.com" rel="nofollow"> <
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Posted By: AnnaShev
Date Posted: 12 July 2011 at 6:48pm
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also who is to say that the midwife you have had your whole pregnancy will be the one who is there on the big day? You could end up with their backup or a hospital midwife. So is that any better? ------------- http://daisypath.com" rel="nofollow"> <
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Posted By: Rachael21
Date Posted: 12 July 2011 at 7:06pm
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That is why not a lot of 18 year olds get into the course. Believe me I totally agree with you on not all 18 year olds are ready for midwifery!
I actually still use the same GP sometimes who delivered me so yes that is continuity of care but in birth GPs are not usually there until the end anyway. The changes to funding had nothing to do with GPs they just made it so midwives were paid the same as GPs for doing the exact same job. Does anyone have ideas on how to keep midwives in New Zealand if these new plans come into play? Overseas midwives cannot work as LMCs until they have done extra training. Student midwives are trained to be LMCs, they have done numerous hospital shifts as well as the fact there are always two midwives at every birth. Courses have to be done every year to keep your practising certificate as well as a standards review every two years. New grads have to do the review in their first year out. When booking an LMC ask how many years they have been out, that way you can get someone you are comfortable with. I think every woman should have the right to choose their LMC and I think the changes will make that impossible, probably not in the next few years but eventually a shortage of LMCs will become apparent again. |
Posted By: Rachael21
Date Posted: 12 July 2011 at 7:10pm
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If it is a back up hopefully you have met her and she will stay for the whole labour and birth. Also birth is not the only part of having a baby, antenatal and postnatal care is equally as important and having the same person can really enhance this care also.
If you (you as in any person reading this) don't want a midwife as an LMC that is fine, noone is forcing you to and we are so lucky to have that choice. But a lot of women do want a midwife so this is about them and ensuring there is that choice for them. |
Posted By: Puddleduck
Date Posted: 12 July 2011 at 7:35pm
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My two cents - I would absolutely support a compulsory mentoring year in hospital for MWs. During my nursing degree I completed over 1800 hours of clinical by the time I graduated. But in my new graduate year working in hospital I learnt more than I did in my entire degree. There is a huge difference in looking after patients as a student and looking after them as a registered health professional.
In an ideal world more hospital experience would be available to new MW's. As others have said this is more an issue of exposing new practitioners to a high case volume with a wide variety of women and babies. I do not believe that one year in hospitals would stop those MWs who want to practice with a low intervention rate from doing so once they become LMCs. I also am not sure that sighting low complaint statistics proves that new graduate midwives are any more or less capable than other MWs, more likely this results from having cared for fewer patients over their career and therefore having had fewer opportunities arise where a complaint might be laid. ------------- http://alterna-tickers.com"> 
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Posted By: choco69
Date Posted: 12 July 2011 at 7:51pm
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i think like anything there will always be those for and against changes
personally i am with an OB clinic for the birth of my child, it's not because I didn't believe that MWs wouldn't give me the level of care needed, partly it was due to the fact that the few I initially contacted didn't want me as a client as I am over 40 (and I know other women my age who have had the same problem) that said I have developed a great relationship with the amazing MWs at my OB clinic who are doing part of my pre and most of my post care and believe them to be highly trained and up-to-date (all of them have been independent midwives previously) i do believe that anyone who has completed training (whatever qualification) if they are dealing with possibly life/death outcomes then I would have more confidence if they were mentored and had experience all high risk as well as low risk situations saying all this I believe that we should enable the student midwives access to more pregnant women to 'practice' on ... although as I am a student at uni I went to the midwifery team and volunteered myself as a practice dummy - they said they had never had a pregnant woman volunteer herself before and they preferred to use dummys and actors to prepare the students outside of their clinic duties additionally, in answer to your question R&C if there are changes to be made then one suggestion is that there is a limit to the number of patients a MW can take on and that certainly when they are new that they are mentored and have to work with other more experienced MWs until such stage as they have passed additional development and clinical assessments as part of the full registration - and that all MWs should have to do something so that they are up-to-date with their personal development - just my opinion ------------- http://lilypie.com">  
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Posted By: Lucky apple
Date Posted: 12 July 2011 at 7:52pm
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Interesting discussion.
I don't think I'm going to add a whole lot, but will put down a few points that I've thought of as I've read... I really like the continuity of care provided by an LMC. I think that part of the current model of care is good. I think we have some great midwifes in NZ. I would also have liked the old model...I too have had the same GP for a number of years & when I visited her to confirm my pregnancy she too said that she would have loved to have delivered my baby & that she really missed that part of the job. I would have loved her to be my primary carer too. Re: extra supervision before practicing independently - be this hospital or community based - I support this initiative in principle. It's all about safe practice and gaining experience. It's a very important job that LMCs have, and in my view, the more experience the better. So many other health professions have a great deal of supervised practice before working independently (and the supervision/mentorship is not optional) - ie nurses with new grad programme; psychologists 1500hrs supervised practice and weekly supervision for first two years of independent practice (following 6 years study to qualify!) - and peer supervision thereafter; Doctors 5 years study + 1 year as trainee Intern + 2 or 3 years house surgeon + 3 to 6(or more) years registrar before becoming a consultant; A GP trainee, already a doctor before specialising as a GP, spends first year of postgraduate study having intensive supervision. So...I don't necessarily think that the proposal for further supervision/experience prior to independent practice is out of sync with what other professions are required to do. A midwife's job, in some instances, involves life or death decisions....the more experience & support the better in my view!! |
Posted By: kandk
Date Posted: 12 July 2011 at 8:06pm
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Continuity of care doesn't always work in pratice!
I was assigned a mw from my small town practice, and saw her or her back up for the first seven months. Then for the birth I had to be in Chch so I was at St Georges, with another lovely mw and her student. And the mw team leader. But they weren't on duty on the weeklend when DS decided to come, so I had a pair of hospital mws whom I had never met. But their shift finished half way through delivery, so I am fairly sure I got another two for the final stages! Then of course a few days in St Georges seeing whoever happened to be around at the time, before heading home. My original mw was on holiday, so I saw a different two mws for the follow up, plus the lactation consultant as a stand in when they couldn't make it! So I make that 12 people involved in my care. All really nice, but not exactly what I was expecting from our system! ------------- http://lilypie.com">  http://lilypie.com">
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Posted By: T_Rex
Date Posted: 12 July 2011 at 8:13pm
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Wow.
My midwife has a shadow student for the second half of this year. She's been at 2 of my appts now, and will probably be at the rest, and come to the birth too. She'll see all of my MW's and the back-ups patients for the next 6 months. She'll learn not just about birth, but about pregnancy, and about post-natal care. She'll be involved in my birth plan discussions, and she'll get to help me remember how to BF. She'll witness a range of births, and she'll get to learn about the early warning signs that need to be picked up on during pregnancy (hopefully not from me though!!). Midwifery is SO much more than just birth and I don't think you'd get as much of the antenatal and post-natal care side of it in the hospital. Personally, I'm a homebirthing mum. And I'm so glad I have the choice. Just as I'm glad those of you who prefer hospital care or OBGYN care can choose that instead. Imagine if you HAD to have a homebirth? That's how I'd feel if I HAD to have a hospital birth. Not everyone will make the same choice, and that's ok. But it's so important that we HAVE choice. ------------- http://lilypie.com">  http://lilypie.com">
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Posted By: Puddleduck
Date Posted: 12 July 2011 at 8:31pm
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T-Rex, why would MWs doing a new grad year in hospital mean you missed out on an opportunity to home birth? I dont think that is what anyone is suggesting in this thread.
You are absolutely right that postnatal care is so so important. I can only comment from my own experience but during the five days I was in hospital I had awesome care from very competent MWs who helped me immensely with latching, breastfeeding and caring for my demanding wee man. ------------- http://alterna-tickers.com">
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Posted By: AnnaShev
Date Posted: 12 July 2011 at 8:54pm
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After reading on the ministry of health (MOH) website I have found that you have a GP or midwife as your LMC. You choose them from a list sent to you by the MOH.
If you have complications you are refered to a specialist. So to apply this to my situation (with help from the southern district health board website) when I get pregnant: there are no GP's within Southland who provide LMC care, so that leaves a midwife for LMC care while the MOH gives you a list of midwives in your area in Southland you apparently have to ring the maternity unit and they assign a midwife to you as all client allocations are done through them (again this is based on me in Southland not a random anywhere in NZ also am unsure as to the reasoning behind this)this has been told to me by many of my friends with young children btw. There are a limited amount of OBGYN consultants based Southland. Further research has found that no OBGYN's are actually in Southland and Otago OBGYN's run clinics in Southland as needed. So much for freedom of choice, the only choice i get is... o wait i dont get a choice but if someone does find a choice please let me know as i cant find it I found my choice, i can choose not to become a parent  ------------- http://daisypath.com" rel="nofollow"> <
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Posted By: NobodySpecial
Date Posted: 12 July 2011 at 8:58pm
Well it could in a way, not for her, but in the future for her children. For example here in Christchurch, they took 3 new grads last year i think Rach said. So 17 missed out. Where and what do those 17 do? Go to another country to work. What happens when all the current midwives are retired? Including home birth midwives? Who is going to replace them? In 10-15 years time what if there isnt enough midwives left and the only option IS hospital birth? |
Posted By: Nikki
Date Posted: 12 July 2011 at 9:02pm
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I think a year in a hospital after studying would be a great idea. Like many have said its standard practice in other health areas, and I think there would be alot to learn in that environment about both normal and more complicated pregnancy / birth situations. Also agree the mentoring should be mandatory.
And if it has any positive impact on the relationships between LMC midwives to be and the hospital staff they have to work with for a year that would be great too (as there seems to be a war between the midwives and doctors from what I have heard ... resulting in midwives refusing to call OBS until things really go bad - and not great outcomes for mums or bubs). Like Anna I would like the old system back. I consider myself to be VERY very luck to have had my GP as my LMC. She has been my GP for over 15years so that is true continuity of care - she is now by kids GP too. She also assisted in my emergency c section (instead of leaving cos she isn't getting paid her final payment if it results in c section as I've heard of some midwives doing) so was there right through to helping me BF afterwards. The funding cuts are what has pushed GPs out which I think is really sad. She does it for love, not money. There are only a few left in the country now. As an example - she gets a grand total of $50 for all post-birth visits to the hospital - so for some women or bubs with complications she will visit 3-4 times - it doesn't even cover her petrol to get there! (and she is cancelling appts in her clinic that make her money in that time!). She has a good 15 years training (med school, internship, GP training, OBS training, Gyne training) versus the 4 years for a midwife. So what change would I like to see in the system? More funding for GPs so other women have the choice I had - to have their GP as their LMC and not just the options of midwife or pay thousands for a private OBS. ------------- DS (5yrs) and DD (3yrs) |
Posted By: Puddleduck
Date Posted: 12 July 2011 at 9:12pm
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Nobody Special - ok I see how you could make that point. However if the newgrad MW's were only employed on a one year contract with funding arranged for this (presumedly if MOH want this to happen they would have to finance it too) then this might create more positions for employment. As with everything in health care there are no easy answers and money will always be an issue.
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Posted By: Quieteyes
Date Posted: 12 July 2011 at 10:49pm
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As a nurse who underwent a graduate program, I support a similar system for newly qualified midwives. I don't feel it has anything to do with whether the training to date has left them competent.. Rather I recognise that the first year (or two) are the most difficult, and having supportive oversight can make for a much more successful and rewarding career.
And yes, hosptal, because I believe in order to support healthy birth processes, a midwife needs to have a good level of experience to allow recognition of complications at the earliest sign, and this helps them develop the confidence to access the appropriate supports/interventions without feeling this detracts from their professional abilities. |
Posted By: HoneybunsMa
Date Posted: 13 July 2011 at 3:21pm
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I think the mentoring programme would be great, perhaps they could add that on as another year or even 2? You would be surprised how many hours a student mw has to do. My SIL did physio (yes different but just as an example) and I think she only had placement in her final year with maybe a couple more in her third year.
I don't think people are thinking clearly about a new grad being an LMC. First a new grad probably wouldn't do a home birth they are more likely to do a birth in a hospital or birthing unit where there are other more experienced MW's on duty so if there is need for intervention, they are unsure about something there is someone to ask. I remember being in labour and the hospital MW popping in and staying behind the curtain to see if my MW needed anything. If there is proper hand over being done at the beginning of each shift and the hospital knows when you check in and that you have been there for an incredibly long time they are likely to check in especially if it is a new grad. My MW also left me in the middle of labour, she told me she had things to do other mums to check on but she was staying central. A) I was tired so didn't care B) my partner was with me and we were coping fine... easier to yell at him when she wasn't there lol C) the hospital MW's knew I was there so checked on me D) I had been awake for 20something hours and my body wasn't doing its thing just right hence being tired. If we felt uncomfortable she would have stayed I'm sure of it. Puddleduck your right you probably did learn alot more in your first year in Nursing at a hospital then you did in your entire study, but they are slightly different. I feel confident that we train our MW well (not saying we don't train our nurses well) but that they are given free reign so to speak on their own cases with someone just watching, and not holding their hand. (Can't tell you what its like for nurses as don't know any in training) but I believe that most student MW get assigned cases while still studying and they are essentially the LMC for that patient. They are up at the crack of dawn if it is needed because their mum has gone into labour just as any MW would be hence showing them the "real world" of being an LMC. As for the prenatal and postnatal care, there is nothing that a new grad can't do that someone who has years of experience can't do. Your prenatal visits are peeing on sticks, and checking levels making sure you go to get your proper bloods etc. I believe nursing is different, you can either work in a hospital or work in a clinic or A&E without trying to sound hypocritcal I would be surprised if many Dr's surgeries that would hire a new grad as they would be lacking that experience and I view it as the job you get after you've put the hard yards in and worked in a hospital setting. My MW with over 10yrs experience was still consulting with an OB when my urine came back with protein. ------------- http://www.myfitnesspal.com/weight-loss-ticker"> 
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Posted By: Rachael21
Date Posted: 13 July 2011 at 4:23pm
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Can I also point out a whole year has been added to midwifery education 2 years ago. This extra year includes hospital shifts and LMC work. As well as ongoing education and 2 yearly reviews forever. Midwives are closely monitored their whole working life.
It is known that midwives in larger hospitals are more likely to use intervention so whether or not this is transferred when they become LMCs is questionable I agree. Thank you for all your replies it is interesting to hear different views. Obviously it is something I am passionate about and I think for sure it will have impact in years to come. |
Posted By: TrinaL
Date Posted: 13 July 2011 at 6:37pm
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Just my 2 cents worth but bar a couple of small things I had fantastic care from the hospital midwives during my delivery and post care. Then fantastic support from a post care midwife at home.
If you read my notes you would think I was a prime candidate for intervention ( I was through the high risk clinic hence no LMC. But I just had the midwives and delivered with no interventions. Only saw the registrar for stitches. The BFing support was amazing and one of the only reasons I am still feeding If there is a round two I would seriously consider the same approach again - I am sure I would still be considered high risk due to age and medical condition. On the flip side a fair number of friends with babies the same age would not choose the same midwife. I also think it is a farce that they say if you don't like your LMC you can change them. Try doing it. I think every situation is individual and each woman needs the options to make her own choices (and change them if she wants. For every bad story you hear about a hospital midwife there is a comparitive one about an independent one and vice versa. Each midwife is different- I had some issues with a couple I talked to about some of my choices and found some of them were very politicised. Fine but don't use that on me and support my right to make my choices. |
Posted By: T_Rex
Date Posted: 13 July 2011 at 8:19pm
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Rach&Jack, is there somewhere I can get more information about what is being proposed? I'd like to share it with a few people, and although I think your account is excellent and raises some really good points, I'd like to link them straight to the source if I can?
Interestingly, it's my uncle's 55th birthday today, and my granny decided to share his birth story with the family email list. She laboured on her own in an 8-bed maternity ward, with one set of doctors and nurses who delivered the babies in turn. She was told to wait until they could get to her before she delivered. Then the baby was trucked off to the nursery and she didn't see him until he was 3 days old. And she finishes off by saying it was a pretty good birth. Imagine that being so normal that she thought that was pretty good?! Midwives are one of the best things that have happened to women and childbirth. Midwives being forced to train in hospital takes away their choice to spend that first year (under mentoring) training in homebirth. It's a big call to go out and start doing homebirths on your own following a year in a hospital setting. I can only presume less of them would do it than if they could make that choice to train under a homebirth MW than in hospital. ------------- http://lilypie.com"> http://lilypie.com">
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Posted By: CarrieMum
Date Posted: 13 July 2011 at 8:48pm
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I would agree with all new grad midwives do at least a year in hospital before they are let loose independantly on the public. Im an RN and had to do a new grad year, I think midwives need this grad year even more than RN's if they're going to be out there working autonomously out of the hospital environment without major support.
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Posted By: Nikki
Date Posted: 13 July 2011 at 9:29pm
It a big call to go out and start doing homebirths on your own first year out of training with no hospital experience! A year in a hospital would be very helpful if a new grad is going to be an LMC in a homebirth situation. theres nothing stopping someone who wanted to do this to spend a year working with an experienced homebirth midwife after the year at hospital. More training / experience / mentoring has got to be a good thing in any life and death situation. Would you want a surgeon operating on you who had only been training for 4 years? How many new grad midwives would be able to deal with a baby that comes out with serious issues in a homebirth? (Time taken to realise what is wrong and get an ambulance could be the difference between life and death) ------------- DS (5yrs) and DD (3yrs) |
Posted By: jazzy
Date Posted: 14 July 2011 at 8:26am
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I think about time. I can only see advantages in this.
Nothing stopping a women from having a natural home birth & it can only be better with someone who has training & knowledge in all aspects & have attended difficult births. If it was not for the hospital teams I had with all my births either my baby or I would of been in serious trouble that an inexperienced M/W with only home birth experienced would not of been able to handle. If you have ever had a baby you know that things hardly ever go to plan & having someone birth your baby with hospital experience can only has to be a good thing... |
Posted By: fire_engine
Date Posted: 14 July 2011 at 10:43am
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I'm in two minds.
I see Rach's point about where are these jobs going to come from. However, as a health professional (and someone who has researched how clinical reasoning develops post-qualifying), I do see a lot of advantages in having an internship year. In my job, you can potentially kill someone if you stuff up really really badly and that is one reason it is very rare to have new grads go into community posts. If they do, they are very closely monitored, with usually weekly supervision, some joint sessions .... I have worked in acute settings with seriously ill, high intervention patients in a medical model of practice, through to community settings - very patient-centred, low intervention with a person-centred model of practice. I am not predisposed to the medical model b/c of my time in acutes; instead it has informed my practice and vice versa. I feel I am a better professional having worked in different settings, in different models of care. ------------- Mum to two wee boys |
Posted By: Guest_55127
Date Posted: 14 July 2011 at 1:51pm
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I am really happy with the system we have here in NZ. it's so nice to get to know a midwife and have her with you throughout the whole thing. I had absolute trust in her and we had a really great relationship. It would be really hard to have that kind of security with rotating midwives.
Also my good friend is a student midwife in her 3rd year and she was there at the birth of our little girl. I felt that she was right up there in her level of knowledge as my midwife who had been practising for many years. (not just saying that because she's a friend) During her training she has had to do quite a lot of time in a hospital with an on call midwife. I personally think that is enough. However she is also a trained nurse so maybe that helps her level of experience and ability in a situation where things may not be going 100% smoothly. 
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Posted By: clover
Date Posted: 14 July 2011 at 3:30pm
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I think that having a compulsory year in a hospital first is actually a good idea. I can see why those studying don't like it but I think it would be beneficial to women. I loved my MW with 25+ years experience, I wouldn't have had a new graduate but that is just me. ------------- http://lilypie.com"> 
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Posted By: AnnaShev
Date Posted: 14 July 2011 at 5:22pm
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If anyone is interested there is an article in the August 2011 North and South magazine about our current maternity system. ------------- http://daisypath.com" rel="nofollow"> <
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Posted By: Looey85
Date Posted: 14 July 2011 at 5:40pm
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This really concerns me.
I was a second year student midwife when i got glandular fever last year and had to stop. I would eventually like to go back. But if this is the way of the future, then I will definitely have to rethink. To me... this sends the message that birth is increasingly medicalised... and that is not what midwifery is about. Also.. I've heard some comments in this thread that seem to imply student midwives have no hospital experience when they come out of training. I can safely say, that is not the case. When I got glandular fever last year it was after practically living in the hospital as well as other placements, antenatals, postanatals, births (in AND out of the hospital) and there was only more and more to come for the rest of the year, not to mention 3rd year. I also had to do pre-healthm sciences before starting midwifery, and midwifery in itself is a 4 year degree crammed into 3 years. It really shows me how naive a lot of people are about the training student midwives receive and the support available after they graduate. Anyhoo... I definitely would not be happy, to spend my first year in practice in a hospital setting. It is not the reason I chose to get into midwifery, and to me, sends the wrong message. And as a few have said, where would these jobs come from? Just my 2 cents 
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Posted By: LittleBug
Date Posted: 15 July 2011 at 10:09pm
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Looey85, I am with you.
I'm a second year student midwife at the moment, and seriously, I live in the hospital and the homes of women. Practical experience in the hospital starts right from first year (just observing, doing non-invasive assessments and attending births, etc.), goes through second year (doing anything and everything, highly supervised), and third year (practising as a hospital and LMC midwife, but heavy supervision and still being 'assessed'). The workload is extreme, and 24/7. We do many, many hours. For those that are talking about mentoring in the first year of practice - currently 98% of the new graduate midwives are in the mentoring programme, and the other 2% are not practising or are practising overseas. So there would be no difference if it was made compulsory. The North & South article - don't even get me started. Clearly there are many people out there that don't understand midwifery, or the training, or the payment schemes. As for breastfeeding being better supported in the hospital, I disagree. Most women find their experience better once they get home, as in hospital there are a million people trying to tell you how to do things differently (there are many ways to bake a good chocolate cake), and women get confused and anxious about the conflicting advice. Personally, I would quite like to work in the hospital when I graduate, as I have a young family and the predictable hours would be nice. However, the local hospital can only afford to take one graduate midwife each year. But my passion lies with being an LMC. I hate the impression that people have of midwives, thinking they can't get their heads around things that deviate from normal. The truth is that yes, we want to protect people from unnecessary intervention (I have already seen atrocious things that are unwarranted, in my short time in midwifery). And yes, our scope of practice is normal, meaning if things become complicated, we collaborate and refer care on to a specialist. But we are also extensively trained about complications of pregnancy, labour and birth. We have been in hospitals. We have worked in NICU, and with the paediatric and obstetric teams. We are taught a great deal about pathologies that occur during pregnancy, and underlying conditions that are affected by pregnancy. Just because we promote the normal, it doesn't mean that we aren't trained for when things go wrong. Midwives have to complete neonatal and maternal life support courses every year. They are constantly reviewed. And they are one of the few health care professions that are required to reflect on their practice regularly as part of a monitored portfolio, for their entire career. They are also required to do a certain amount of hours doing additional learning (attending courses, skills workshops, etc) each year. As for when things do go wrong and a midwife has been in the media for making a mistake - don't judge a whole profession by a highly publicised few. I understand that there is political motivation to make midwives look bad, and there is some tension between some of the midwives that were required to do nursing first and direct entry midwives. There is a lot of history there. But the truth is that there are just as many obstetricians (and other health professionals involved with childbirth) that can't do their job well, but they get protected by their profession and aren't dragged through the media. And while it's awful that bad things happen, the truth is that childbirth doesn't always end well for women and babies, despite being given the best care possible. It is understandable that people want someone to blame, and new midwives are easy targets. But the statistics show that new graduate midwives practice just as safely as other experienced lead maternity carers. I am not defending those that haven't done their job properly, but please don't judge the rest of us at being at their level. Imagine if everyone did that to you, in whatever profession you are in. It's not very nice. My only complaint with the profession is that we get very little thanks for the amount of work (and stressful work) that we do. That, and people often seem to think that I must be some lesbian, feminisist, hippy, witch, man-hating radical who hates medicine and can't get on with a doctor, just because I'm studying midwifery. I don't fit that profile at all. ------------- Chloe (4 years) and Oliver (3 years). |
Posted By: Looey85
Date Posted: 16 July 2011 at 7:17pm
Beautifully articulated LittleBug 
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Posted By: InthemiddleMummy
Date Posted: 16 July 2011 at 10:14pm
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in Timaru we can choose an independent midwife or a shared care either OB/hospital MW or GP/OB/Hospital MW.
I understand this is a little different to other districts? I personally liked the shared care system and choose 3 way care all 3 times. I get to see the GP for free whenever I want to for pregnancy related issues, or MW which ever I choose, then if they think I need to they refer me to OB. But also have scheduled OB visits at 13,20,28,34,36,38,40++ squeezed in between that is MW & GP visits I found it good as get to see my GP whom knows me since I was born, get to see the same MW each visit who is specialised trained in birth comes to my home etc after bub born, and get to see the OB whom is called into check progress when in labour and stays if required alongside the MW. I was so glad I was in a hospital situation when things started to go not to plan and baby didnt pop out in the waterbirth plan I had expected. MW wasnt worried about her paycheck being reduced and calls the OB & back up ward MW the instant she is concerned. OB whom ended up doing the forceps/episiotem/ventouse, & then c/s for 2nd birth is the same gyno Ive had forever, also calls everymorning to check on you when in hosp, afternoons are the Lead MW visits, and obviously you get the rotational MW staff whom are amazing everytime you push a buzzer and also just popped into check on you if you hadnt been called on for a few hours. Personally for me I have no idea how b/f can be established at home with a MW that visits once a day? I had to push the buzzer everytime to latch and at one stage had the head MW, ward MW & lead MW in with me all discussing my bf issues / resolutions and helping me to BF. I had to express / tube finger feed / syring feed / use nipple shields to establish successful b.f and if I had been send home after 48hr with my first Im not sure what would of happened I think we need to go back to longer hospital stays if mothers want to establish bf and recover better. for the naturalist that want to go home 3hr after birth all well and good, but people like me I feel I had brilliant care with my 3way care system. Very well looked after. Im not sure I would be happy to have just one MW caring for me. I like the security of lots of knowledgeable hands on deck |
Posted By: Puddleduck
Date Posted: 17 July 2011 at 9:34am
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I bought North and South so I could read the article on midwifery. I actually thought it made a good point, that there needs to be better record keeping around births/outcomes and interventions so that the success or not of the LMC system can be seen.
But what really stuck out to me was the attitude of Karen Guililand, chief executive of the College of Midwives. I understand that she is sick and tired of these sorts of articles, but her dismissive attitude of what is a real concern for many people (she went so far as to say that concern over midwifery care is a rich white women's problem) does not help. As for midwives not receiving enough thanks for their work - my first one clearly felt this way since she bought up different thank you gifts she had received at each one of our visits including monetary values. The implication was very clear and unprofessional in my opinion. ------------- http://alterna-tickers.com">
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Posted By: Plushie
Date Posted: 17 July 2011 at 10:57am
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Girls_Rock i had the same issues with breastfeeding, in fact i was kept in hospital longer then the standard 24hrs because i literally couldnt latch without help, in fact couldnt latch without the help of one specific hospital midwife. However i had an independant and she was great and i'm sure if i was at home she would have sat there all day with me if she had to. Once i was home and still struggling she did call the LC on behalf to get her over.
Puddleduck one of the midwifes that cared for me in hospital said something similar - something about when they give 'extra care they normally get a little something as thanks' i was like um, not from me you won't! Shocker! |
Posted By: MissCandice
Date Posted: 17 July 2011 at 11:07am
Could you tell me where the response is from the college? Is it a separate article? ------------- ~ Mummy to a beautiful girl ~ |
Posted By: fairy1
Date Posted: 17 July 2011 at 11:37am
This shocks me. I am a nurse and neither myself or anyone I know would ever consider asking for gifts, we go as far when people ask what they can give us to say thank you we say please don't give us anything. ------------- http://lilypie.com">
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Posted By: Puddleduck
Date Posted: 17 July 2011 at 2:27pm
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Miss Candice it's in the main article in the column to the right of the picture of the GP. I dont have the magazine in front of me but I'll find out exactly what she said and where it is and post it later. ------------- http://alterna-tickers.com">
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Posted By: karenb_chch
Date Posted: 17 July 2011 at 2:48pm
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I really like the continuity of care model during pregnancy. Unfortunately, there is very little choice in most places. When I first became pregnant, I would have prefered a GP as my LMC. My GP told me that there is exactly one GP in Chch who works as an LMC, and they don't take new clients. So my choice was either a midwife, or paying for a private OB (not an option). In the end, I found an absolutely fantastic midwife, and experienced wonderful care, but I would like to see a greater range of options for women.
My personal experience was that, overall, I got far better care from my LMC than I did from hospital midwives. I spent 4 days in hospital recovering from a c-section, and then learning to cope with the damage that my daughter did to my nipples! It was 3 days before I saw an LC, despite asking within the first 24 hours, and after the first couple of days, I actually had to buzz the midwives to ask for my pain relief - if I forgot that I was due some, I often didn't get any! Some of the hospital midwives were lovely, some were useless, and one was an absolute biarch. I would expect that all student and new graduate midwives already get a considerable amount of hospital experience, as many women will choose to birth in a hospital. Perhaps the changes could include a requirement that all midwives who specialise in homebirth have to have a certain period of time practicing first, so that they have seen most of the things that can go wrong ... ------------- http://lilypie.com"> 
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Posted By: LittleBug
Date Posted: 19 July 2011 at 4:14pm
That is really shocking!! I hope you wrote about that on her feedback forms. When I said we get very little thanks for what we do, I was referring to bad publicity and misunderstanding due to maternity politics, poor pay for the hours that are required, 24/7 workload, etc. ------------- Chloe (4 years) and Oliver (3 years). |
Posted By: LittleBug
Date Posted: 19 July 2011 at 4:20pm
I agree that birth outcomes and interventions need to be recorded better. What I do not agree on is the biased way in which the article targeted midwifery as a profession. Better recording of data needs to happen throughout the whole maternity sector, not just midwifery. No where in the article does it say that New Zealand has one of the best maternity care systems in the world. ------------- Chloe (4 years) and Oliver (3 years). |
Posted By: fairy1
Date Posted: 19 July 2011 at 6:43pm
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Personally I wouldn't classify $80,000 for a caseload midwife as bad pay. ------------- http://lilypie.com">
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Posted By: clover
Date Posted: 19 July 2011 at 7:46pm
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LittleBug I really enjoyed reading your post, thank you for your perspective it really did give me a better knowledge of the role of the midwife.
I'm still not sure that I see the proposed changes as a bad thing but I'm clearly not close enough to the situation to have an informed opinion. All I hope is that whatever changes are made that they are best for the women, the midwives and also for the babies. ------------- http://lilypie.com">
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Posted By: LittleBug
Date Posted: 20 July 2011 at 1:11pm
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You would have to be doing more than the recommended caseload to be earning $80,000 a year, fairy1. I know some midwives do take on a huge caseload, though, depending on availability of other midwives in the area. If you worked out an hourly rate for the amount of time that is expected to be spent with each women, it's not actually that much. Especially if an awful lot of that money is spent on travel costs.
Clover, I don't see the postponed changes as bad either (except I don't think it would practical or even possible for all midwives to be employed in hospitals in the first year out). I'm all for changes that are best for women and babies (and midwives of course). The thing that I am opposed to is the way that the magazine attacked midwifery as a profession, it was scaremongering and biased, and ill-informed. ------------- Chloe (4 years) and Oliver (3 years). |
Posted By: MissCandice
Date Posted: 20 July 2011 at 1:18pm
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Littlebug, you have said everything that i wish i could have said myself!
This article is from yesterday:) http://www.infonews.co.nz/news.cfm?id=71283 - NZ Midwifery World Leader ETD: I cant spell lol ------------- ~ Mummy to a beautiful girl ~ |
Posted By: fairy1
Date Posted: 20 July 2011 at 4:44pm
I'm not having a go at you or anything I just think the pay is fine as per the MECA contract http://www.nzno.org.nz/LinkClick.aspx?fileticket=tPeOIPuySOw%3d&tabid=224 - here . It says that caseload midwives receive $82,083 per year. ------------- http://lilypie.com">
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Posted By: MissCandice
Date Posted: 20 July 2011 at 5:57pm
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. ------------- ~ Mummy to a beautiful girl ~ |
Posted By: scribe
Date Posted: 20 July 2011 at 10:21pm
??? That's a press release, not a news article! (Sorry, but as a former journalist I just had to comment )
I think we do have a good maternity system but I suspect it could do with some tweaking, and I thought the N&S article raised some good points. While it may not work in practice, I think a year in hospital after training would be a great idea. Also, I think it is unfortunate that GP care is no longer an option ... perhaps women could have the option to 'top up' the government subsidy? That would take some pressure off midwives too? |
Posted By: Hopes
Date Posted: 21 July 2011 at 7:59am
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I actually think I'd rather have a midwife than a GP - although my GP is AMAZING, and I love her to bits and feel very lucky to have managed to get her as her waiting list is mammoth, she still spends most of her day seeing coughs, colds and sprained ankles. Midwives spend most of their time seeing pregnant ladies and babies. In saying that, I'm all for it being a more viable option if people wanted it.
That salary - or a bit less if that's not quite standard - sounds pretty reasonable for what's a responsible job. I'm not sure what your average nurse gets, but I know they start on about half that (I imagine midwives start on a lot less too) -------------
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Posted By: jazzy
Date Posted: 21 July 2011 at 8:28am
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As for pay it will be like any job, your pay will be based on your experience & your contract.
I was talking to a m/w I worked with prior to having DS1 who is 10yrs old, she was on nearly $80k a yr she worked at the hospital in a team & had a partner back up. She had to deliver a certain # a yr. Now I thought that was a good pay for 10+ yrs ago. At the end of the day I want the person who has experience & is going to be able to handle any curve balls thrown. So I can only see a good stint in a hospital as an advantage...for the patient & them. The opportunities the m/w will have in their future has to be a bonus. |
Posted By: Nikki
Date Posted: 21 July 2011 at 6:22pm
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My GP sees mainly pregnant ladies and bubs, as shes one of only two still delivering in auck! If there were more GP/OBS still delivering they would have more pregnant ladies and bubs in their waiting rooms like my GP I'm sure.
The pay seem pretty good. My sister is a nurse with over 15yrs experience and earns NO WHERE NEAR that! ------------- DS (5yrs) and DD (3yrs) |